Speak Up For Communication

With absolutely no mention of decorating downstairs toilets this week, I am back talking about the serious matter of children’s speech, language and communication needs – SLCN.

Last year, I wrote this post – Ensuring Children’s Speech and Language Needs Are Met: A Call to Action– about The Bercow10 report – a damning reflection of the state of speech and language therapy services in the UK and the enormity of unmet need. RCSLT and ICAN last week began a new campaign highlighting the changes that have been successfully brought about in the year since Bercow10 and asked for renewed efforts to speak up for SLCN.

Of the 47 recommendations made in last year’s report, 17 have already been fully actioned, which is a promising start.

You can see some of the key successes here:

Bercow10 key successes

I mentioned the petition begun by @GillianRudd at the end of last year’s blog post. Following an incredible effort, this was successful, gaining 11,622 signatures and leading to a debate in Parliament. The government have stated they are committed to meeting the needs of children with SLCN, and Teresa May herself has committed to change during Prime minister’s question time.

However, there is widespread agreement within the speech and language therapy profession that this is not enough. Budget cuts have decimated speech and language services up and down the country. Yesterday, there was an article in the Daily Mirror about children languishing on waiting lists for as long as a year before getting any sort of meaningful help (see Mirror Article). The NHS department I used to call my professional home no longer exists – its contract having been lost to a private provider – and those children I work with in independent practice talk of long waits, minimal input and quick discharge in their NHS services. I never thought I would have to end up working privately to be able to give children the quality therapy they deserve and part of me is still saddened by it, not least because private services are out of reach for so many vulnerable children who need them.

Pressure on NHS speech and language therapy departments has been growing over a number of years, with an increase in need and a decrease in funding. Clinicians are under pressure to move children through services as quickly as possible and to be inventive with the budgets they do have. The department I worked for, put a heavy emphasis on others, such as speech and language therapy assistants and teaching assistants, carrying out therapy with children. This was part of being ‘lean’ and making savings but ultimately I think it has devalued the work and knowledge of speech and language therapists and contributed to the demise of services. We also worked to an ‘episodes of care’ model, in which children were seen for a block of therapy to target a specific aim and then discharged, with the plan for them to come back again when they needed more. Although this was effective for some children – the ones whose parents or school would make sure they did come back – I’m sure it put vulnerable children with poorer support networks at increased risk. Although the service was designed for children to come in and out of, I think it gave the message to some people that nothing else could be offered and that children’s needs had resolved, where they hadn’t, and were unlikely to for their lifetime. In trying to be frugal, I suspect some services have inadvertently misrepresented the severity and long-term nature of some SLCNs as well as lessening children’s chances of getting the additional support they needed at school (funding is difficult to justify if a child isn’t actually under any external services).

As it stands, Little Bear has also been discharged from speech and language therapy. He too could be re-referred but that would require energy I’m not sure I have. I would need to prove his needs were severe enough to get through referral criteria and no doubt start back at the beginning of the initial assessment to waiting list process again, which took a year last time. He clearly does have ongoing needs – he has Developmental Language Disorder – but proving the daily impact on him would be difficult now his needs are more subtle. Like any parent of a child with SEND, I am already pretty stretched with managing behaviour, seeking funding, trying to get school to understand his needs etc. etc. I’m not sure that I should have to jump through hoop after hoop to get him the help he needs. Yet I would have to. And so too do parents of children with SLCN in all corners of our country.

For me, it has been far easier to create a speech and language therapy programme for Little Bear myself and to train his TA to carry it out myself. Clearly this is a perk that other parents cannot rely on.

The majority of clinicians want what’s best for children and many are deeply frustrated by the limits of the services in which they work. In an unprecedented move, RCSLT and ICAN wrote an open letter to government last week, asking for SLCN to be given the attention it deserves. It was countersigned by 60 organisations, ranging from Autism charities to fostering and adoption charities, who share a deep concern about the future of children with communication difficulties. You can find it here: Open Letter

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Five key areas requiring change have been identified as priorities for action and are the five areas the open letter asked the government to act upon. They are:

Joint commissioning of Services – as SLCN impacts upon children’s emotional wellbeing, education, future employability and likelihood of involvement with the criminal justice system, a joined up approach to meeting need would be ideal. It is hoped that this would also help to iron out the postcode lottery which currently exists in the provision of speech and language therapy services.

Long-term support for SLCN – although support has improved in the early years, support for the 10% of older children and teenagers who will have ongoing needs continues to be poor.

Professional Development – there is a pressing need for all teachers and those working in the field of childhood mental health to be aware of SLCN and the many ways it might present. Professionals need to be able to identify SLCN and be aware of clear pathways to support.

Incentivising schools – budget cuts are impacting on education settings too. In these times of reduced funding and fewer EHCPs, it is imperative that schools are supported from the top down to identify and meet SLCN. The anniversary report asks for provision for SLCN to be considered during Ofsted inspections.

Supporting vulnerable groups – as children who have been excluded from school, those in Care, those with mental health difficulties and those who are involved with youth justice are more likely to have SLCN and are more at risk of their needs going unidentified, improvements need to be made to the support available for these groups as a priority.

This is the main area where I have tried to make an impact – providing training workshops for adopters and prospective adopters to arm them with knowledge of communication development; how to identify red flags and what to do to best support SCLN at home. Myself and another speech and language therapist adopter have also written a social communication group specifically for children with trauma backgrounds which is currently being advertised. It is good to see that work is beginning to happen with children who have experienced, or still are experiencing the Care System in other areas, and training for speech and language therapists in this previously neglected area is becoming more common too.

There are pockets of hope but in short, our work is far from done. RCSLT and ICAN are asking for our ongoing activism. We need to continue speaking up for communication and for children with speech, language and communication needs. We cannot stand by and do nothing.

If you would like to help, here are some things you can do:

  • Use the hashtags #SpeakUpForCommunication and #SpeakUpForSLCN on social media
  • Make a Vox Pop clip to pledge your commitment to speaking up for SLCN and share on social media (advice here: Vox Pop Guidance ) . I’m still pondering how I can get involved with this anonymously…
  • Visit the website here: www.bercow10yearson.com where you can download speech bubbles and get tips on other ways to join in
  • Write to your MP, or tweet them. Are they speaking up for communication? They are our representatives in Parliament – we need them to know about SLCN and Bercow10. We need them to speak up most of all.
  • Retweet and share this blog
  • Tell anyone who will listen about SLCN

Perhaps if we all shout loud enough, real change will happen.

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Speak Up For Communication

Support

Support can come in many forms and from a range of sources and this week we have experienced some of them.

The first thing was that we got an outcome on the funding application we made to the LA for additional support for Little Bear on his transition to year 1. We had not applied for a full EHCP but for ‘top-up funding’, of which there are several levels. This is short-term funding, just for the next academic year. It avoids a full assessment (which is required for an EHCP) but obviously does not give the long-term commitment and legal obligation of an EHCP. The point of top-up funding is to support “accelerated progress” for those children who need it. We felt this was ideal for Little Bear because given his background (neglect) he does need more support to catch up with his peers and it is difficult to say at this stage whether he will continue to need that throughout his school life or not.

Our application for funding was supported by the school and the Educational Psychologist and we had all contributed to the paperwork. We know that the leap to a more formal education in year 1 will be huge for Little Bear and that he will still require access to the EYFS. We also know that Little Bear needs very specific and 1:1 support to learn new tasks and to move forward with his educational targets – I wrote about the type of support that makes a difference to him last week in Jigsaws. Therefore, we were all agreed that additional funding would be required, on top of the £6000 the school are obliged to provide from their SEN budget.

On Wednesday the SENCO was waiting for me when I came to pick Little Bear up from school. “Have you seen the letter?” she said, “we’re fuming!”. I had not seen the letter as although the LA had addressed it to me, it hadn’t (and still hasn’t) found its way here. She ushered me in and we went through to the office she shares with the Head to read it. The first thing I noted was that the letter referred to Little Bear in his birth name. I have no idea how that came about as he has been legally adopted for over a year now and neither school nor us had used that name on any paperwork. It is quite concerning that the name is still in circulation and still on somebody’s data base somewhere.

The letter itself said that the LA were rejecting our application for funding as it had been sent in on the wrong paperwork (it hadn’t), Little Bear was making “excellent progress” and there weren’t any Speech and Language targets even though we had talked a lot about his Speech and Language Needs (there were targets included with the application). This was very annoying and disappointing. However, school had been very proactive and the Head had already phoned the LA and given them a telling off. He had got them to agree to read the paperwork properly and to take it back to panel, which happened to be taking place the next day.

Although I was annoyed, there was nothing I had to do as school had handled it and I felt reassured that they were on our side and were prepared to fight for Little Bear, just as I would be. I do feel lucky that this is the case as I’m only too aware of others in a similar position where the school would not have supported their application in the first place. Other schools would have just accepted the rejection letter and would not have queried it and the outcome would have been completely different.

When I shared what had happened on Twitter, it was lovely to get virtual support from friends and people I have never met who were outraged on my behalf.

Last night, I got a call from the SENCO. They had heard back from the LA, who had evidently realised they had cocked the whole thing up and who had now read the application properly and have granted us the funding! In fact, now they’ve thought about it, they have seen fit to grant us a level higher than the one we actually applied for.

I’m so happy that this has been resolved as I really feel it will make the difference between a rocky transition and Little Bear being able to do the very best that he can next year. Getting the right support in place for him is absolutely essential and thanks to the ongoing support we receive from school that has now been achieved and they are looking at employing a TA.

 

The second bit of support I got this week was rather unexpected. Little Bear has not been well at all. He had a course of antibiotics a couple of weeks ago but it has made little difference. He has a horrible cough and is just not himself, even though he is still running about all over the place. I have been umming and erring about taking him back to the doctor for a few days now but I had to go myself on Tuesday and sat waiting for over an hour and a half in the ridiculous ‘sit and wait’ clinic they operate. The thought of sitting there for that length of time with Little Bear filled me with dread so I have to admit I was avoiding it and hoping he might miraculously recover. When I saw his pale face and not as enthusiastic as usual running at sports day yesterday I knew I really did have to take him.

I decided to call them and be honest: maybe they could help me out by letting me have an actual appointment slot? I wasn’t too hopeful as the receptionists at our doctors are just like everywhere else – a little scary and you have to basically beg and give them far too much medical information to even have a chance of getting in.

I rang them anyway though and explained that Little Bear has some difficulties with behaviour and cannot tolerate waiting for a long time. I felt a bit fraudulent doing it though I’m not sure why as it is true. There weren’t any slots yesterday but the lady assured me that if I called in the morning they would be able to help me. A while later she called me back and said someone had just cancelled, would I like to book their slot? It was really good of her to take the time to remember us (they must get loads of calls) and to bother to find my number and call me back. This morning she called me again – the doctor had phoned in sick but she had jiggled things about so we could still have an appointment.

We have now been and only needed to wait 15 minutes which was much better. Little Bear was hanging off the reception desk and licking my arm and running about so I think they could see my issue!

Once again I feel lucky that when I asked for the support, it was there. I suppose it was a small thing but it did make a big difference to my day.

 

The third type of support I have observed this week was from Big Bear towards Little Bear. At sports day whenever Little Bear was participating in a race, Big Bear and the entirety of his year 3 class chanted and shouted for him. It was lovely.

 

This week I have also run one of my Communication Workshops. It was attended by prospective and current adopters. I love meeting other adopters in this context as hearing their stories is always so interesting. Sometimes I meet someone who is having a hard time of it and I can really sense their anxiety and worry and their being constantly on the brink of tears. I think it’s because I can see myself in the early days in them. I tend to go home and think about them a lot and hope they have the support around them that they so badly need.

Adoption is not an easy route. There are so many things that we have to constantly have on our mental agendas, so many things we have to chase up and even fight for. Good support is absolutely critical. I am, as ever, incredibly grateful for the support and kindness we have been shown, not just this week but every week. I know others are not so fortunate but I do think it is reassuring for us all that good support does exist and can be found somewhere.

 

Support